Scot. moo. J., 1975, 20 : 109
URINARY ZINC IN HEPATIC CIRRHOSIS J. G. Allan, G. S. Fell and R. I. Russell Departments of Gastroenterology and Clinical Biochemistry, Royal Infirmary, Glasgow
Summary. Plasma Zinc and renal clearance of Zinc have been studied in patients with various chronic hepatic disorders. Plasma Zinc levels were reduced in patients with all forms of chronic hepatic disease and were of no value in differentiating these conditions. The renal clearance of Zinc was found to be significantly higher in patients with chronic hepatic disease of alcoholic aetiology (1.25 ml.fmin.) compared with those of non-alcoholic aetiology (0.52 ml.fmin.) and normal subjects (0.33 ml.] min.). The renal clearance of Zinc may be of value in identifying chronic hepatic disease in which alcohol is aetiologically involved.
is known to be present in many enzyme systems such as alkaline phosphaZ tase, alcohol dehydrogenase and carbonic l N C
anhydrase. It is also required for nucleic acid and protein synthesis. However, it is only recently that any definitive physiological role has been attributed to the trace metal. A syndrome of dwarfism, hypogonadism and anaemia corrected with oral zinc has been described (Prasad et al., 1963). Improved rates of healing of surgically induced wounds and venous stasis ulcers, similarly treated, have also been reported (pories et al., 1967; Husain, 1969). Halsted and Smith (1970) demonstrated reduced plasma levels of zinc in a wide range of conditions and such a finding is considered to be a somewhat nonspecific indicator of active disease. The aim of this study was to assess the value of plasma zinc and renal zinc clearance estimations in differentiating various forms of chronic hepatic disease. Patients and methods Patients. Patients admitted to hospital for the investigation and management of chronic hepatic disease were studied. The non-alcoholic group consisted of patients with primary biliary cirrhosis, cardiac cirrhosis, active chronic hepatitis and cryptogenic cirrhosis. The plasma zinc and renal zinc clearance was measured in these patients and the results compared with those obtained from a group of normal control subjects. The patients were fully investigated in terms of hepatic function by standard liver function tests including serum albumin and globulin, immunoglobulins, serum transaminases and by isotope scan of liver. Hepatic biopsy was performed when coagulation mechanism permitted. A full history regarding alcohol consumption was taken from all the patients and their relatives. All patients with chronic hepatic disease had normal renal function. Whole blood was collected in lithium EDTA bottles with the minimum of stasis and the plasma
separated within one hour of collection. Haemolysed specimens were discarded. Urine was collected over a 24-hour period into plastic containers free of zinc, S ml. of 10 per cent thymol in isopropanol being added as preservative. Zinc content was measured by direct comparison with similarly diluted standards on a Perkin Elmer 403 Atomic Absorption Spectrophotometer using the direct digital read out in concentration units. The between batch precision of the method had a coefficient of variation of less than S per cent.
Results Plasma Zinc. The mean plasma zinc (±S.D.) in all patients with chronic hepatic disease was 71 ± 16 iLg. per 100 ml. (Table I). This level was significantly lower than that of a normal control series (102 ± 11; P
URINARY ZINC IN HEPATIC CIRRHOSIS J. G. Allan, G. S. Fell and R. I. Russell Departments of Gastroenterology and Clinical Biochemistry, Royal Infirmary, Glasgow
Summary. Plasma Zinc and renal clearance of Zinc have been studied in patients with various chronic hepatic disorders. Plasma Zinc levels were reduced in patients with all forms of chronic hepatic disease and were of no value in differentiating these conditions. The renal clearance of Zinc was found to be significantly higher in patients with chronic hepatic disease of alcoholic aetiology (1.25 ml.fmin.) compared with those of non-alcoholic aetiology (0.52 ml.fmin.) and normal subjects (0.33 ml.] min.). The renal clearance of Zinc may be of value in identifying chronic hepatic disease in which alcohol is aetiologically involved.
is known to be present in many enzyme systems such as alkaline phosphaZ tase, alcohol dehydrogenase and carbonic l N C
anhydrase. It is also required for nucleic acid and protein synthesis. However, it is only recently that any definitive physiological role has been attributed to the trace metal. A syndrome of dwarfism, hypogonadism and anaemia corrected with oral zinc has been described (Prasad et al., 1963). Improved rates of healing of surgically induced wounds and venous stasis ulcers, similarly treated, have also been reported (pories et al., 1967; Husain, 1969). Halsted and Smith (1970) demonstrated reduced plasma levels of zinc in a wide range of conditions and such a finding is considered to be a somewhat nonspecific indicator of active disease. The aim of this study was to assess the value of plasma zinc and renal zinc clearance estimations in differentiating various forms of chronic hepatic disease. Patients and methods Patients. Patients admitted to hospital for the investigation and management of chronic hepatic disease were studied. The non-alcoholic group consisted of patients with primary biliary cirrhosis, cardiac cirrhosis, active chronic hepatitis and cryptogenic cirrhosis. The plasma zinc and renal zinc clearance was measured in these patients and the results compared with those obtained from a group of normal control subjects. The patients were fully investigated in terms of hepatic function by standard liver function tests including serum albumin and globulin, immunoglobulins, serum transaminases and by isotope scan of liver. Hepatic biopsy was performed when coagulation mechanism permitted. A full history regarding alcohol consumption was taken from all the patients and their relatives. All patients with chronic hepatic disease had normal renal function. Whole blood was collected in lithium EDTA bottles with the minimum of stasis and the plasma
separated within one hour of collection. Haemolysed specimens were discarded. Urine was collected over a 24-hour period into plastic containers free of zinc, S ml. of 10 per cent thymol in isopropanol being added as preservative. Zinc content was measured by direct comparison with similarly diluted standards on a Perkin Elmer 403 Atomic Absorption Spectrophotometer using the direct digital read out in concentration units. The between batch precision of the method had a coefficient of variation of less than S per cent.
Results Plasma Zinc. The mean plasma zinc (±S.D.) in all patients with chronic hepatic disease was 71 ± 16 iLg. per 100 ml. (Table I). This level was significantly lower than that of a normal control series (102 ± 11; P
